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Background <p>As of 2023, 25.5% of live births in France are from mothers who were born abroad. Women born in sub-Saharan Africa are especially at risk of maternal and neonatal morbidity and mortality. Intermediate explanatory factors probably include access to and quality of care. The BiP multidisciplinary mixed-methods project sought to explore implicit racial biases among prenatal practitioners as one of the first approaches to this issue in France. The qualitative component we present here aimed to explore the clinical relationship between women from different migration backgrounds and healthcare providers as well as possible racial-based differential care in the setting of prenatal care.</p> Methods <p>A sociological qualitative study was conducted in three public maternity units in the Paris area among 6 obstetrician-gynaecologists, 6 midwives, 6 anaesthesiologists, and 148 pregnant women. The study was based on audio-recorded prenatal consultations and self-confrontation interviews with practitioners. Consultations and interviews were analysed thematically.</p> Results <p>The countries of birth and social positions of the participating women were globally similar to those of the pregnant women seen in each maternity unit. The content of care was globally controlled by healthcare providers and consultations were slightly longer for immigrant than native women; the explanations they provided were appropriate to women’s level of understanding. The prenatal follow-up, when standardised, left little room for differential care. Nonetheless, the tone of voice and the type of jokes showed the salience of the social relations of race and class, beyond the strict framework of the care relationship. A few instances of racism in care were identified and analysed, but their consideration by the institution was non-existent.</p> Conclusions <p>French research is beginning to produce data on racial discrimination in healthcare, and this qualitative study provides an in-depth understanding of mechanisms leading to less adequate care, which was not an everyday occurrence. Despite the inclusion bias inherent in this type of approach, this study produced original results about the differential care of women who are immigrant during hospital prenatal care.</p>

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Differences in hospital prenatal care between immigrant and native women in France: a qualitative study within the BiP research on racial implicit bias in perinatal care

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  • 发表日期：

    2026年2月10日

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  • P. Sauvegrain,
  • M. Cognet,
  • O. Anselem,
  • J. Richetin,
  • C. Deneux-Tharaux,
  • A. Rousseau,
  • M. P. Bonnet,
  • E. Azria

摘要

Background

As of 2023, 25.5% of live births in France are from mothers who were born abroad. Women born in sub-Saharan Africa are especially at risk of maternal and neonatal morbidity and mortality. Intermediate explanatory factors probably include access to and quality of care. The BiP multidisciplinary mixed-methods project sought to explore implicit racial biases among prenatal practitioners as one of the first approaches to this issue in France. The qualitative component we present here aimed to explore the clinical relationship between women from different migration backgrounds and healthcare providers as well as possible racial-based differential care in the setting of prenatal care.

Methods

A sociological qualitative study was conducted in three public maternity units in the Paris area among 6 obstetrician-gynaecologists, 6 midwives, 6 anaesthesiologists, and 148 pregnant women. The study was based on audio-recorded prenatal consultations and self-confrontation interviews with practitioners. Consultations and interviews were analysed thematically.

Results

The countries of birth and social positions of the participating women were globally similar to those of the pregnant women seen in each maternity unit. The content of care was globally controlled by healthcare providers and consultations were slightly longer for immigrant than native women; the explanations they provided were appropriate to women’s level of understanding. The prenatal follow-up, when standardised, left little room for differential care. Nonetheless, the tone of voice and the type of jokes showed the salience of the social relations of race and class, beyond the strict framework of the care relationship. A few instances of racism in care were identified and analysed, but their consideration by the institution was non-existent.

Conclusions

French research is beginning to produce data on racial discrimination in healthcare, and this qualitative study provides an in-depth understanding of mechanisms leading to less adequate care, which was not an everyday occurrence. Despite the inclusion bias inherent in this type of approach, this study produced original results about the differential care of women who are immigrant during hospital prenatal care.